Meanwhile, a battle against a metal mining industry that has ravaged freshwater supplies in El Salvador shows just how difficult it is for a developing country to build economic alternatives for a water-secure future.

Two mining companies are dragging El Salvador through a costly legal challenge at an international trade tribunal for attempting to protect limited water supplies by refusing permits for their operations.

In 2008, after strong public pressure to protect water from mining, Antonio Saca, El Salvador’s president at the time, declared he would not issue any new mining permits. There are no active metal-mining operations in the mineral-rich country, which a majority of Salvadorans would like to become the first in the world to prohibit metal mining permanently. A bill to ban the industry has the support of more than 62% of the population and was initially backed by the ruling FMLN party.

The canton of San Sebastián stands as an emblem of a past where mining companies were given free rein to mine, resulting in the contamination of fresh water. Milwaukee-based Commerce Group ran a gold mining operation in the area until 1999. The community has nothing to show for decades of gold extraction but the famous bright orange waters of the San Sebastián river, a classic sign of acid mine drainage from large-scale gold mining. The Salvadoran environment and natural resources ministry tested the water in 2012 and found nine times the accepted levels of cyanide and 1,000 times the accepted levels of iron.

Without a clean water supply, local subsistence activities have been devastated. Residents are forced to buy bottled water, but continue to use the highly toxic water from the river for feeding livestock, bathing, and doing dishes.

Experiences like that of San Sebastián have galvanised people in other parts of the country. In the northern department of Cabañas, neighbourhood associations, church groups and environmental groups have organised a strong campaign against a cyanide leach gold mine proposed by Vancouver-based Pacific Rim. With the help of a Spanish NGO, Asociación Catalana de Ingeniería Sin Fronteras, a community organisation in Cabañas has armed itself with an extensive baseline study of its water and started implementing measures to improve water quality. Local groups have also led the national campaign for a permanent ban on metal mining, and were initially backed by the broad-based civil society coalition called La Mesa Nacional Frente a la la Minería Metálica.

As Manuel Perez-Rocha of the Washington-based Institute for Policy Studies observed during a recent fact-finding mission to El Salvador involving 45 international delegates from 12 different countries: “The contrast between the communities exposes the myths of mega mining. Rather than generate wealth for the communities, decades of mining have left the people impoverished in San Sebastián, whereas the communities of Cabañas are well organised and are exploring their own vision for development.”

Salvadorans are simultaneously trying to pave the way for a clean water future through an ambitious new water bill currently being debated at the national assembly. The proposed bill would engage 25 different government agencies in a series of measures ranging from universalaccess to water and sanitation to protecting source water and prohibiting activities that would destroy watersheds. It would establish a hierarchy of water use that would prioritise clean water for human consumption and food production.

Meanwhile, both Commerce Group and Pacific Rim are using a World Bank trade tribunal to circumvent community consent and state regulation. They are suing the Salvadoran government for more than $400m through the International Centre for the Settlement of Investment Dispute (ICSID), whose mandate is to protect investment rights.

The legal challenge appears to have have had a chilling effect politically. Negotiations around policies that would be unfavourable to the mining industry have become gridlocked, and civil society actors fear the ruling party may make concessions to the pro-mining opposition. If ICSID forces El Salvador to pay the companies, it would make goals such as universal access to water and sanitation impossible.

As scientists and world leaders deliberate on how to fix the global water crisis, there should be greater international support for communities and countries attempting to forge new paths away from water-destructive economies. If El Salvador overcomes the odds and becomes the first country in the world to ban metal mining, it could serve as a model for a world grappling with the

the threat of an imminent water crisis.

With a recent poll showing a close race between the ruling party and the pro-mining opposition for the 2014 presidential election, the window for change may be closing.

Sanjay: Bahar maidan mein khel rahi hai, football ke liye ladai kar rahi aur humarein muhn lag rahi hai. (They are playing outside in the field, fighting for the football with us, and talking back to us.)

Me: In teeno mein se, aapko dikkat kis baat se hai? (Out of these three things, what bothers you the most?

Sanjay: Sabhi se hai. Humko teeno ki hi aadat nahi hai na. (All three of them. We are not used to such behaviour of girls.)[1]

On any given day, I would argue with him incessantly, making it very clear that the problem is not with the girls but with him. But, that day, I let him have the last word. Not because I had nothing to say to him, but because I felt a great sense of achievement and pride on behalf of the girls who had upset him and had challenged the patriarchal order and structure which is his comfort zone. He is visibly upset with the young girls in his village who have begun to question his authority. There are many other such men and boys in other villages as well, where the girls have begun to occupy and reclaim spaces like public grounds, which have traditionally been seen to be “male-only” spaces. They are angry, upset, and disturbed by this sudden demand for space by the girls.

The increasing number of female bodies in a playground, running, playing, jumping, laughing, and fighting is upsetting norms, challenging controls, and transforming spaces. These are bodies that are meant to be invisible inside and not visible outside in public spaces. These are bodies that are meant to be monitored and controlled inside homes, those four-walled bastions of patriarchy. In this established order, how they choose to dress, choose to roam, choose to express, and choose to interact with others is not their decision. However, now in small and not-so-small ways, these structures of power, of domination and silencing are being challenged. While some men and boys are not very happy with this overt display of female bodies in the field, there are others who are being supportive and encouraging of this trend. Some react angrily, some positively, and some violently.

It is not just the men and boys who are curious about what is happening. When sessions on topics like bodily changes, menstruation, sex, pregnancy, choice, consent, pleasure, rights, and autonomy are held as part of the It’s My Body programme, many mothers accompany their daughters to these meetings to check what is being ‘taught’. The local health workers are keen to participate in sessions on health, hygiene, nutrition, and menstruation. Sessions on sex, sexuality, choice, consent, and pleasure make them uncomfortable. The discomfort is not just at their end.

We also share this anxiety in talking about these issues freely and openly. The fear of backlash and antagonism makes us choose our strategies, messages, mediums and language strategically and carefully. The title of the programme, ‘It’s My Body’, when translated into Hindi— Mera Sharir, Mera Adhikaar, comes across as ‘bold’ or ‘radical’ and there is some hesitation in using it, both on our part as well as that of organisations co-implementing this programme with CREA[2]. The programme is very often projected as a programme on Reproductive Health, and the ‘S’ and ‘R’ in Sexual and Reproductive Health and Rights are used cautiously. Words like ‘hak’ , ‘adhikaar’, ‘pasand’, ‘anand’ ,’yaunikta’ (right, preference, pleasure, and sexuality)are used selectively and only in certain ‘safe’ settings and spaces. But, what happens, when these conversations are translated into actions outside these constructed ‘safe’ spaces?

When Rashmi (name changed),from Jharkhand, insisted on wearing jeans in the village, her mother pulled her out of the programme. Neha (name changed) has refused to marry the boy her parents chose for her because she doesn’t like the way he looks. Her parents are shocked and unhappy with this new assertion of her right to say ‘NO’. Kavita(name changed ) slapped the boy who grabbed her hand at the tea shop. The first thing that she had to explain to her parents, family, and others was – why was she roaming outside the house in the evening? Sunita, Mamta, and Jyoti (names changed ) come to attend these meetings on their bicycles. Some boys hide behind the trees place thorn traps on the way to puncture their bicycles, so that they can trouble and tease them. As a result, the girls have stopped staying back for volleyball practices in the evening and head home before it gets dark.

There are several question marks and circumscriptions outside of these ‘safe’ settings, where girls feel ‘empowered’, informed, and confident. All our conversations and discussions in these spaces and the choices girls make often have repercussions. What is the kind of resistance they face outside these safe spaces? How do they negotiate with those who are not part of this ‘safe’ space? How do they retain this confidence when they are outside this setting? What are the struggles they face to be a part of this group? Why is it that if something goes wrong, it is the girls who have to back down? Why does the fear of harassment, abuse, and violence hold them back from participating in these collectives?

The fear of the consequences for some of these young girls, who are questioning, challenging, and transforming the established social order, is ever-present. This compels us to reflect on our own strategies. We often ask ourselves whether we should tone down the rhetoric? Or should we let this fight run its own course? How do we make our processes of change more inclusive to include others who serve either as gatekeepers or as allies in this process? Creating exclusive, rights affirming and safe spaces for women and girls is necessary. But is that enough when the application of these rights is in the “real world”?

Sanjana Gaind works at CREA as Program Coordinator – Young Women’s Feminist Leadership. Sanjana is interested in the application of artistic and creative methodologies in activism and development. She has used mediums like theatre, music, art and sports in her work with young girls and women on issues of gender, sexuality and rights.

Big Thank You to Meenu, Shalini, Pooja and Rupsa for the ideas and feedback they shared.

[1] This conversation took place with a 26- year-old man in Jharkhand on 11 March 2013, at an International Women’s Day event that was organised by CREA and Mahila Mandal, as part of CREA’s ‘It’s My Body’ programme. Sanjay [(name changed]) is the captain of the village football team.

[2] It’s My Body- Advancing Sexual and Reproductive Health and Rights of Adolescent Girls through Sports, is a programme led by CREA and co-implemented with ten women-led, community-based organisations in rural and urban areas of Bihar, Jharkhand and Uttar Pradesh.

May 1, 2013,

DUBLIN: Irish government ministers agreed draft legislation on Tuesday to allow for limited access to abortion where a woman’s life is in danger, including the threat of suicide, a proposal that has already divided the country’s ruling coalition.

Ireland’s two-decade-old debate over how the government should deal with a Supreme Court ruling that abortion be permitted when a woman’s life was at risk was re-opened last year following the death of a woman who was denied an abortion of her dying foetus.

Successive governments had sidestepped acting on the ruling, the result of a challenge by a 14-year-old rape victim in the so-called “X-case” of 1992 to a constitutional amendment nine years earlier that intended to ban abortion in all instances.

However the death of Savita Halappanavar and subsequent large-scale protests from both sides of the debate spurred ministers into action despite misgivings among some members of Prime Minister Enda Kenny‘s conservative Fine Gael party.

The case of Halappanavar, an Indian dentist living in Ireland, highlighted the lack of clarity in Irish law that leaves doctors in a legally risky position. Critics have said this means their personal beliefs can play a role.

Though the influence of the Catholic Church over society has waned since the 1980s and a younger, secular generation want to stem the tide of Irish women travelling to nearby Britain to terminate their pregnancies, the issue still polarises opinion.

Following an extended Cabinet meeting on Tuesday, the government published the outline of the ‘Protection of Life during Pregnancy Bill 2013′, the contents of which have dominated the political agenda in Ireland in recent weeks.

“The proposed legislation sets out a clear legal framework for women and for medical practitioners in Ireland,” the government said in a statement.

“It will provide legal clarity for the medical profession of the circumstances where a termination is permissible where there is a real and substantial risk to the life, as distinct from the health, of a woman as a result of a pregnancy.”

Backbench rebellion?

On the contentious issue of suicide, the proposed law states that a panel composed of one obstetrician and two psychiatrists must jointly certify that a termination is required to avert a real and substantial risk to the life of the mother.

The government hopes to enact the legislation before parliament adjourns in July and Kenny has said that he expects the government to vote as one on the issue, meaning that any defectors could be expelled from his party.

One backbencher has already said he would vote against the legislation while at least a dozen more, including minister for European Affairs Lucinda Creighton, have said they believe the inclusion of suicide could lead to abortion on demand.

While this would be unlikely to threaten the government’s record majority, it would be a blow for Kenny who, midway through his five-year term, has kept all but one of Fine Gael’s 76 members of parliament on side, even as he pushes through tough austerity measures required under an EU/IMF bailout.

Kenny’s centre-left junior coalition partner Labour, which has expelled five of its members for rebelling against budget cuts, has campaigned for a clarification of the country’s abortion rules and some of its members took to Twitter late on Tuesday to welcome the bill’s publication.

But opponents dismissed assurances by Kenny that the law will be restrictive, with the Pro Life Campaign criticising the government for proposing a law that it said provides for the direct intentional targeting of the life of the unborn child.

Think of one regional language word each for the following: Consent. Assumption. Choice. Pleasure. Agency.

These are some of the words which form the foundation of the world of sexual rights. How many did you get?

How does one talk of sexuality? How does one express desire and consent? How does one articulate violation? What do we call the body parts, what do we call ourselves? How do we claim identities or demand space and rights on sexuality? In societies where conversations about sex are silenced, how do we talk about our everyday lives, which are as much about sexual boundaries and norms as they are about the politics of caste, religion, gender, class and so much more besides.

Working on sexuality in local languages is not only crucial but radical. It is radical because it dispels the myth that most of sexuality work happens in the ‘English world’. It is also radical because it demonstrates that no cultures are devoid of sexuality. This means, saying that “we don’t have the language to talk of sexuality” isn’t correct. A friend from Meem[i], Lebanon, berating the mainstream western understanding around the ‘Middle East’ and sexuality, said recently to me, “it’s not that we don’t talk of sexuality, it could be that we just don’t call it sexuality.”

Also, the concept of sexuality isn’t unpacked in a uniform way everywhere. Different meanings are made of it in different contexts. A group of young girls we work with from Jharkhand, when asked what what they understood by sexuality, said in unison,“sexuality means what we like and don’t like in all aspects of life.”

There are many terms, words and connotations that find space in a regional language, but not in English. Hindi offers the space for many terms that connote a cultural construct – such as Hijra. There is no equivalent term in English for Hijra – the only word that comes closest is ‘transgender’, an unsatisfactory translation. Ruth Vanita and Saleem Kidwai’s work[ii]brings together diverse texts that uncover stories of same-sex desire and gender diversity, spanning centuries of the subcontinent’s history and numerous linguistic traditions. Non-English speaking people have not needed English to claim and articulate their realities. Their lives are lived, and desires expressed in a manner they find appropriate for themselves.

In its initial phase of work, sexual rights activists in India were constantly told that poverty was a far more pressing issue than sexuality. These activists brought forth an understanding of intersectionality as a perspective to do any work related to human rights. This perspective also sheds light on access to language in which work is done and the need to work in different local languages is something that became clear fairly earlier on. Since most of the activists who began this work were themselves urban and English speaking, their work would be inaccessible, possibly culturally-alien, if it remained only in the realm of English. Sexuality is a deeply cultural thing – in terms of its specific taboos, the controls, the ways in which it is allowed to be expressed, the breaking of norms, articulation of experiences which are different, naming desire. In India, how can these multilayered cultural manifestations ever be fully expressed in English, without losing its richness?

A few friends decided to say words which we used for our nether regions. Cunt was one of the most used. We felt very empowered, smugly so. At some point one of us said, but what are the non-english words? We came up with a few, choot being one of them. None of us appropriated a single one of those words for ourselves or our amorous moments. We were empowered in English. Elsewhere, we were as good as people who didn’t/couldn’t say cunt.[iii]

One of the challenges of working in Hindi is that sexualised words often also used as slang, and are therefore considered obscene, or are stigmatised. It could feel less personalised. But what is it really that makes us uncomfortable? Could it be that for the English speaking people, our language of thinking limits our expressions around sexuality?

In this work in Hindi, creating new language, and sometimes modifying the existing language becomes crucial to convey meaning.[iv] In the latest edition of the annual Hindi journal on sexual and reproductive health and rights, Reproductive Health Matters (RHM), themed Abortion and Rights, we wanted to highlight the element of ‘right to choice’ for termination of pregnancy.[v] The popular hindi term, garbh paat seemed stigmatised at one level and on further research, it was clear that its literal translation means miscarriage. To keep the right to choice about one’s body and life inextricably linked to induced abortion, we chose to use a lesser used but thought provoking term, garbh samaapan (termination of pregnancy). Such experiments in translation and creation of a new language to talk about sexuality and Sexual and Reproductive Health and Rights (SRHR), keeps our work political.

Another crucial point is about the kind of hindi scholarship around sexuality being created. Is it influenced by the assumption that theory is for English-speakers, while practice is for non-English speakers? This despite the interconnections between practice and theory, and the influence our everyday worlds and their construction have on theory. The diversity in resources available on sexuality in English isn’t the same as that in Hindi. We felt the need for Hindi RHM, a peer reviewed journal, precisely because such theoretical scholarship was not available for Hindi speaking activists. The Institutes on Sexuality, Gender and Rights in Hindi have as much reading and engaging with theory as the English Institutes.

Sometimes popularising certain English terms may make more sense. The term Intersex in Hindi would be antarlingi. Not only does this term in Hindi have no resonance in colloquial Hindi, it is a highly sanskritised way of using language, which we are, very consciously, trying to move away from. The words sex, transgender, surrogate, sex work are some more of such examples.

As part of our sports and SRHR program, It’s My Body, we produced resources for young girls. We wanted to steer clear of the producing material which looks like SRHR outcomes – HIV transmission and menstruation. We realised that we need to think about the kind of language we want to use. We wanted to talk not only of menstrual cycle, but how young girls should have information around their bodies. We wanted to not only talk of how to have safe sex, but that young people should be able to decide who they want to have sex with, when and also have the knowledge, confidence and agency to be able to say yes, no as well as maybe. We decided to use words like sahmati, poorv-anumaan, chaahat, chunaav, haan, naa, pasand –the language used in the work with the groups of young girls.We designed them in a way so girls can keep them hidden, if they needed to; to take out and discuss and read with peers when they felt comfortable.

A conversation on language and sexuality is incomplete without thinking about who is creating the Hindi scholarship in the sexuality world. The people who live in both ‘English and Hindi worlds’ are different from people who live in ‘Hindi worlds’. If we are clear that practitioners are also capable of creating scholarship (as we should be!), a larger objective of creating Hindi scholarship on sexuality must be to put this work in the hands of people for whom English is not the first language. That will alter the canvas of negotiating the language of sexuality.

Meenu Pandey works as the Program Coordinator – Global South Knowledge Resources at CREA. She works on creating scholarship in Hindi on gender and sexuality. She is the co-editor of Close, Too Close: The Tranquebar book of Queer Erotica.

Big thank you to S. Vinita for thinking this through with me and Sanjana and Vrinda for their very useful feedback.

[iii] An old conversation between a group of English speaking friends.

[iv] This blogpost focuses on Hindi as a language but the arguments are relevant for any regional language.

[v] Reproductive Health Matters (RHM) is an independent charity, producing in-depth publications on reproductive and sexual health and rights for an international, multi-disciplinary audience. http://www.rhmjournal.org.uk/ CREA has collaborated with RHM since 2005 to bring out annual editions of the journal in Hindi.

IMO’s annual conference in Killarney voted down a motion calling for abortionto be allowed in cases where there was a substantial risk to the life of the mother. It also rejected motions on allowing abortion in cases of rape or incest and certain other special circumstances.

This is likely to put the main professional medical body on a collision course with the government which has promised to bring in legislation to make abortion legal in case where the mother’s life may be at risk.

IMO’s move came two days after an inquiry into Savita’s death found that she could have been saved had doctors not focused all their attention on saving the foetus. Doctors refused her repeated requests for abortion even when her life seemed in danger.

“The investigating team considers there was an apparent overemphasis on the need not to intervene until the foetal heart stopped, together with an under-emphasis on the need to focus an appropriate attention on monitoring for and managing the risk of infection and sepsis in the mother,” the inquiry said

Savita, (31) was 17 weeks pregnant when she was admitted to Galway University Hospital on October 21 last year and was found to be miscarrying.

The report by Juan E. Méndez, the U.N. Special Rapporteur on Torture and Other Cruel, Inhuman and Degrading Treatment or Punishment, is cited as a report “on certain forms of abuses in health-care settings that may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment.”

Méndez, a visiting professor at American University’s law school, makes some bold statements in Section B, entitled “Reproductive rights violations.” His assertions show just how far the quest for abortion has come in the world – to a point where the torture of a baby ripped from the womb and sucked away and thrown into a medical incinerator is considered a human right that spares someone else from torture.

Section 46 of his report notes:

International and regional human rights bodies have begun to recognize that abuse and mistreatment of women seeking reproductive health services can cause tremendous and lasting physical and emotional suffering, inflicted on the basis of gender. Examples of such violations include abusive treatment and humiliation in institutional settings; involuntary sterilization; denial of legally available health services such as abortion and post-abortion care; forced abortions and sterilizations; female genital mutilation[.]

To compare involuntary sterilization and female genital mutilation – permanent methods of actual torture – with the denial of a “right” to take another life is tragic. In fact, it doesn’t actually line up with the U.N.’s own statements.

Considering that, in accordance with the principles proclaimed in the Charter of the United Nations, recognition of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world,

Recognizing that those rights derive from the inherent dignity of the human person …

The U.N. then goes on to define what torture is:

Article 1

1. For the purposes of this Convention, the term “torture” means any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity.

Clearly the U.N.’s version of torture doesn’t seem to allow for the killing of a baby in utero, but Méndez does. Though many current exceptions to abortion laws note that “mental suffering” is justification for that exception and include it as a health reason to have an abortion, the comparison of who suffers more, a woman who carries a baby to term and gives the baby up for adoption or the one who lives forever with the reality of choosing to kill her baby, cannot adequately be evaluated by one man making a report to the United Nations.

While it would be wrong to assume that a woman carrying a child she is not prepared to raise would not be painful, it is also wrong to call it torture. Torture would be punishing her for the pregnancy or forcing her to raise a child she isn’t prepared to raise. However, the real torture is inflicted on the baby in her womb, who will be sucked out and discarded if that abortion happens.

Méndez goes on to note that:

For many rape survivors, access to a safe abortion procedure is made virtually impossible by a maze of administrative hurdles, and by official negligence and obstruction. In the landmark decision of K.N.L.H. v. Peru, the Human Rights Committee deemed the denial of a therapeutic abortion a violation of the individual’s right to be free from ill- treatment. In the case of P. and S. v. Poland, ECHR stated that “the general stigma attached to abortion and to sexual violence …, caus[ed] much distress and suffering, both physically and mentally.”

It’s unquestionable that a rape survivor who gets pregnant (notably, this is about 1% of all rape victims, so not a majority of those seeking abortions, though a valid minority) needs great care. The tragedy inflicted on her must be handled well, but the torture has come from the rapist, not from the denial of taking another life. Our torment should never allow us the right to kill another. A culture that seeks to nurture and care for victims of torture needs to put its focus on caring for the victim, giving resources, and providing many other solutions that will help heal the tragedy by giving a woman lasting comfort to the effect that she has helped to redeem a tragedy, not to create another.

Méndez is insistent that denial of abortion is torture, though, for all cases. He says in section 50:

The Committee against Torture has repeatedly expressed concerns about restrictions on access to abortion and about absolute bans on abortion as violating the prohibition of torture and ill-treatment. On numerous occasions United Nations bodies have expressed concern about the denial of or conditional access to post-abortion care. often for the impermissible purposes of punishment or to elicit confession. The Human Rights Committee explicitly stated that breaches of article 7 of the International Covenant on Civil and Political Rights include forced abortion, as well as denial of access to safe abortions to women who have become pregnant as a result of rape and raised concerns about obstacles to abortion where it is legal.

Here forced abortions are presented as on par with denial of abortion. But the fact is, they are not. A forced abortion takes a life, and the denial of abortion saves one. A forced abortion can never be undone. A woman is subjected to the horror of having her body violated (possibly a second time, if she was a victim of rape), and knowing life has been taken from her. Denying someone a right to have a life taken is not torture; it’s a basic human right for the unborn life.

By all accounts, Méndez would consider the North Dakota legislature torturers for deciding that life begins at conception. He would consider Kansas and Arkansas as inflicting torture for passing laws that protect life. However, denying abortion isn’t torture, because the motive isn’t torment; the motive isn’t to make someone suffer, but to prevent the suffering of the baby destroyed and of the mother, who will have to live with it.

The extra tragedy in this culture of death is that we have walked forward into the past, where we justify death as a merciful thing, when truly it brings destruction. Méndez has stretched the definitions to a point that distorts them and, in the process, manages to reduce the true suffering of victims of such horrific crimes as female genital mutilation to the level of carrying a living baby to term. Protecting life can never be equated with killing it.

I was appalled to read a recent newspaper article that reported a government ban on irreversible methods of contraception. Later I learned that the ban prohibits non-governmental organizations (NGOs) from the provision of sterilization services. According to reliable sources, sterilization services continue to be available through the public sector albeit with additional counseling requirements implemented at some points of access. As this newspaper item coincided with protests against ‘family planning’ held by extremist Buddhist factions concerned about the diminishing ‘Sinhala race’, it is surprising that neither the government nor the Ministry of Health has thus far provided clarification on this issue. In this article, I would like to highlight a few problems with the existing sterilization policy that are unlikely to be resolved through bans or other forms of restriction. Rather than restricting women’s access to contraception to accommodate the views of reactionary groups, it might be more useful to focus our efforts on addressing some of the issues outlined below.

General Circular No. 1586 issued by the Office of the Director General of Health Services (1988) includes the following eligibility criteria for sterilization procedures: “1) The clients should be over 26 years of age and should have at least 2 living children; the younger being over 2 years of age. Confirmation of mother’s age should be done by checking the Birth Certificate, Identity Card or any other valid document, which is available; 2) Clients who are over 26 years of age and having 3 or more living children could be sterilized at any time; 3) A client under 26 years of age, and his/her spouse insist on a sterilization, the Medical Officer concerned could use his/her discretion, and perform the sterilization provided the couple has a minimum of 3 living children. In such a situation the officer concerned should personally check the validity of the information provided, in respect of the number of living children, prior to performing the sterilization; and 4) In the event of any medical indication, which warrants sterilization, the client should be referred to a specialist in the relevant field who should make the final decision.”

As the subtext of the circular implies, like most contraceptive programmes offered through Ministry of Health, the criteria for sterilization target women. For instance, references to the “mother’s age” and the insistent appeal of the spouse (when the ‘client’ is under 26 years) suggest that women are primary targets of the sterilization programme. In my experience of working for the Ministry of Health, sterilization procedures were, in fact, freely available and did target women, both in terms of availability and accessibility. This is confirmed by data from the most recent Demographic and Health Survey (2006/7): 16.9 % of ‘currently married women’ were sterilized compared with 0.7% of women whose husbands were sterilized (the Demographic and Health Survey is administered to married women and specifies these categories). These statistics must also be considered in light of the fact that the sterilization procedure for men is ‘simpler, safer, easier, and less expensive’ than the procedure for women (WHO, 2007).

Importantly, the criteria listed on the circular do not require the ‘client’ to obtain her/his partner’s consent to undergo sterilization (although spousal insistence may add weight to requests from those who are under 26 years of age). Nevertheless, spousal consent is routinely obtained in government institutions before providing sterilization procedures to women (my experience; see also CEDAW Shadow Report, 2010). In my work, I witnessed numerous instances when women’s pleas for sterilization were rejected during Caesarean section simply because the spouse was unavailable to sign a consent form. If these women decide to undergo sterilization on a later date, they are exposed unnecessarily to a second surgical procedure. In this way, doctors take on the role of gatekeepers to contraceptives services, restricting women’s access based on their own gendered presumptions.

The Circular of 1988 referenced above was introduced because “[it had] been observed that a significant proportion of females who [underwent] sterilization [were] under 25 years of age, with a notable number being less than 20 years” (General Circular No. 1586). These concerns were valid in the 1980s, a time when coercive tactics were being used as part of the population control agenda imposed on the third world. In 1980, a monetary incentive of Rs. 100 per sterilization procedure was introduced and was subsequently increased to Rs. 500. Surprisingly, this monetary incentive was not omitted in the Circular of 1988 and remains in place today. In fact, another circular was introduced in 2007 in order to “streamline” the payment process so that ‘clients’ would be able to obtain this payment from the institution that provided the sterilization procedure (General Circular No. 01-09/2007). Furthermore, healthcare providers (including the surgeon, anaesthetist and assisting nurses) can still claim, if they so do wish, a negligible sum for sterilization. While Rs. 500 may seem trivial to some of us, continuing to provide incentives for sterilization is problematic and warrants omission.

The provision of incentives can be interpreted in many ways, especially when sterilization procedures are mostly sought by particular groups of women. Sterilization is most popular among women in the plantation sector (presumably not Sinhala contradicting the claim of extremist factions in Colombo). According to the Demographic and Health Survey (2006/7), 61% of estate women used a modern method of contraception (including sterilization, contraceptive pills, intra-uterine devices, Depo-Provera, implants, condoms and complete breastfeeding) and 41% resorted to sterilization. In contrast, 54% and 44% of rural and urban women used modern methods of contraception, while 16% and 13% resorted to sterilization (the survey used urban, rural and estate as distinct categories). This set of data completely debunks the proclamations of extremist Buddhist groups who are hell bent on protecting Sinhala women from coercive sterilization. It also makes it incumbent on us to ensure that plantation workers are not coerced into sterilization. On the other hand, the large numbers of estate women accessing sterilization may signify a lack of access to temporary contraceptive options.

Imposing restrictions on sterilization may have other implications for women’s health. For instance, it is likely to increase the incidence of unplanned pregnancies. According to the Demographic and Health Survey (2006/7), sterilization is popular among the following categories of women: estate women, women above 35 years of age, women with lower levels of education and women with three or more children. While these associations may point to a need to ensure that these particular groups of women are not coerced into sterilization, it also reflects on who will be most affected by restrictions on sterilization. Not surprisingly, this profile bears similarity to that of women seeking abortion services; induced abortion is most common among rural, married women with at least two children (Senanayake & Willatgamuwa, 2009). Then restrictions on sterilization could result in more women resorting to unsafe abortion, a service that has moved underground since the government led shut down of abortion clinics in 2007.

Religious extremism is frequently accompanied by restrictions on access to reproductive health services for women. Although the existing policy is problematic for the reason that in targeting women it burdens them with the responsibility of adopting contraceptive measures, the policy does ensure that sterilization is quite easily accessible to women through the public sector. While there is much room for improvement around health policies governing contraceptive services, such as the removal of incentives and the unofficial requirement of spousal consent for sterilization, imposing restrictions or banning sterilization altogether is hardly the solution. Such restrictions are not only an extension of policies that assume that women are incapable of making decisions concerning their health, but may well be interpreted as an attempt by the state to regulate women’s reproduction in the service of a retrograde agenda of nationalism.

As the battle to preserve reproductive freedom heats up, abortion-rights advocates are increasingly embracing the quest for “reproductive justice.” Younger activists predict 2013 will be the year “choice” fades out.

Fans of the phrase say yes, now that mainstream abortion-rights groups have started using this term alongside (or in favor of) the word “choice.”

Via Facebook and Twitter, they predict 2013 will be the year “choice”–like the bloomers worn by Seneca Fallsactivists in the 1840s and the bellbottoms favored by Gloria Steinem in the 1970s–moves into feminist history.

Some activists argue that “reproductive justice” should supersede “choice,” just as “LGBT” came to replace “homosexual.” Others claim choice is a better rallying cry because it is time-tested, punchy and decisive. But both sides agree the abortion-rights movement is under intense fire. Its need for fresh support is the reason some activists are pushing for new language now.

At the January 2012 West Coast Rally for Reproductive Justice, activists used both phrases in the chants they bellowed and the placards they hoisted while thronging the streets of San Francisco. And while gearing up for the 40th anniversary of (the Supreme Court decision that legalized abortion on Jan. 22, 1973), abortion-rights activists started using reproductive justice in addition to choice to frame their discussions and garner support.

The National Organization for Womenn and Medical Students for Choice are now using both terms freely. And on Jan. 15, Planned Parenthood, the largest provider of abortion services in the United States, announced it was formally embracing reproductive justice, boosting the term’s popularity–and the controversy surrounding it.

‘Changing of the Guard’

This shift in semantics represents what Monica Raye Simpson, director of the Atlanta-based SisterSong, calls “a changing of the guard.”

Coined in the 1970s in the burgeoning feminist movement by women struggling for autonomy, choice spoke to what was then on the agenda: empowering women to have control over their own reproductive destinies. Being pro-choice came to mean supporting a woman’s right to safe, legal abortion.

“We realized choice was an aspiration and not a reality for many of us, and was too narrow to speak to people without privilege,” says Eleanor Hinton Hoytt, president of the Black Women’s Health Imperative, inWashington, D.C. “We decided what we needed was reproductive justice–the removal of the structural inequalities that blocked our access to choice.”

As defined by Simpson of SisterSong (a health group for women of color that has promoted the new phrasing), reproductive justice means “the right to have a child, the right not to have a child and the right to parent your children and control your birthing and childrearing options.” This term encompasses not just the stand-alone subject of abortion, but the greater socioeconomic, political and racial context surrounding it.

“Inequality exists, and reproductive justice is meant to shine light on that,” says Nicole Clark, a health consultant in New York City.

Proponents of reproductive justice say prioritizing this concept over choice means putting the horse before the cart and ensuring that choice will indeed become a reality.

Planned Parenthood announced it was adopting reproductive justice alongside choice the same day it launched a public-awareness campaign to show “how the pro-choice and pro-life labels don’t reflect the complexity of the conversation about abortion, and the way that Americans think and talk about abortion today.”

Dawn Laguens, executive vice president of Planned Parenthood, told Women’s eNews, “We believe this way of framing the conversation will make it more robust and allow everyone who wants to have this conversation to find their way in.”

Expanding the Conversation

Just who are mainstream organizations trying to engage in conversation?

First, they are reaching out to women of color, who did not have adequate representation in the feminist movement in the 1970s and who have since then launched vibrant initiatives of their own (such as theNational Latina Institute for Reproductive Health, in New York City, and Forward Together/ Asian Communities for Reproductive Justice, in Oakland, Calif.). Today, women of color represent a vital share of the broad-based women’s rights leadership.

These groups are also trying to garner support from “millennials,” born after the year 1980, who say they favor reproductive justice over choice because it is more fluid and all-encompassing.

“People in my generation say ‘I’m not a feminist, but I believe in those ideals,'” says Kelsey Warrick, 19,president of the student group Hoyas for Choice at Georgetown University in Washington, D.C. “They say, ‘I’m not pro-choice, but I support the right to choose.”

Also receptive to the reproductive justice label are the growing number of Americans who express ambivalence about abortion. A January 2013 NBC poll showed 70 percent of people believe \should be upheld even if they would not chose to have abortions themselves. Paradoxically, a May 2012 Gallup poll showed only 41 percent of people identify as pro-choice–a record low since polling began.

“Given the reality of 3-D sonograms and technology that pushes back the time of viability, there is growing cognitive dissonance over the issue of abortion,” says Charmaine Yoest, president of Americans United for Life, an anti-choice group in Washington, D.C.

Infusing New Vitality

Just as it is being used to speak to a younger, more diverse and more ambivalent audience, reproductive justice is also being used to infuse new vitality into the long-embattled abortion-rights movement.

Though nearly 1-in-3 American women terminate pregnancies by age 45, their access to abortion is far from secure. Starting with the 1977 Hyde Amendment, which denies abortion-care coverage to low-income women on Medicaid, a steady barrage of anti-choice measures have slowly chipped away at Roe.

In the last two elections, Republicans–many of whom are staunchly anti-abortion–seized majority representation in both the U.S. House of Representatives and the state legislatures. In 2011 and 2012, Congress considered 14 anti-choice measures, with some of the most extreme ones defeated only narrowly. State legislatures enacted a record number of such provisions (a total 135 in 2011-2012). And on March 6, Arkansas passed the earliest-term restriction in the nation, outlawing most abortions after 12 weeks.

Today, Arkansas, Mississippi, North Dakota and South Dakota have just one surgical abortion clinic per state. So-called TRAP laws, which promote “targeted regulation of abortion providers,” have further undermined the protections provided by Roe. In Virginia, a new rule requires clinics to have hallways that are five feet wide–or shutter their doors.

In the past 30 years, reports New York City’s Guttmacher Institute, the number of U.S. abortion providers has dwindled 40 percent, and 87 percent of U.S. counties now have no abortion provider at all.

“We need language that motivates people,” says Jon O’Brien, president of Catholics for Choice, inWashington, D.C. “We need to get them to stand up and defend women’s rights.”

In a New York City theater lobby, surrounded by women’s rights advocates before a production of her play, “Words of Choice,” feminist writer Cindy Cooper furrowed her brow, then shrugged.

“I’m working with activists from all over the globe, and they’re using reproductive justice more and more while simultaneously using choice,” she said. “But the semantics don’t matter much to me. What matters to me is what works.”

Govt Bans LRT on Women and Vasectomy on Men After Bodhu Bala Sena Protested Against Birth Control to Protect Dwindling Sinhala Race

24 February 2013, 6:10 am

By Chrishanthi Christopher

Last week the government sent out a communiqué to all government hospitals and private institutions banning all irreversible family planning methods that control birth.

Following the ban Maternity Hospitals and Non Governmental Organizations (NGOs) that do Ligation and Resection of Tubes (LRT) on women and Vasectomy on men shelved their plans and struck off all scheduled procedures from the hospital registers. This follows an announcement by the government that the procedures should not be carried out on women and men unless it is done for medical purposes.

Maternity Hospitals, Gynaecology Units of Base Hospitals and NGOs dealing with population control came under deep shock. They say that the government’s call comes without any warning.

Health Ministry, Secretary, Dr. Nihal Jayatilake said that the procedure hitherto being done on men and women should not be carried out unless it is for a medical reason. He refused to explain the reasons for the ban but stressed that none of the NGOs are allowed to carry out any permanent birth control methods. “This is government policy,” he said.

Ironically this call come at time when the Bodu Bala Sena (BBS), a movement claiming to be protecting Sinhala culture and values called on the government to put an end to all irreversible methods of birth control claiming that the Sinhala nation is dwindling.

Against their will

They say that women and men of the productive age group are pushed into accepting the procedure against their will by certain NGOs who have vested interests. The BBS General Secretary, Gala Boda Atte Gnanasara Thera told Ceylon Today that the Sinhala women who go to the hospitals to give birth are unwittingly opting for the procedure. He blamed the midwives and attendants in the hospitals for misleading young mothers who come there for confinement. “They are trained to advocate the procedure to young mothers. We are against this type of behaviour. Our women are misled or pushed into believing that they should not have more than two children,” he said.

Gnanasara Thera said that the Family Planning Law of 1973 is outdated and cannot be applied today. The Act states that women in the age group of 26 years and above are eligible for family planning “Those days men and women got married early and they had many children at that age. But now they start life at 30 years,” he said.

“The government has got to intervene and ban the procedure before it is too late. There is a conspiracy, our Sinhala population is declining,” Gnanasara Thera added.

He claimed that in the Tamil populated areas, the doctors inform the women and men of the repercussions of the surgical procedures and do not advocate it till they are over 40 years.

Government has to intervene

Pointing a finger at the NGO Marie Stope International, he said that funding for the birth control procedures are done by them. In addition he says that illegal abortions are also being carried out by the institution. “They have a sinister aim behind it,” he said.

However, the Family Health Bureau and the Family Health associations who are in collaboration with Marie Stope International and help it perform the sterilization procedures say that it is totally wrong to say that the mothers and fathers are pushed into this. “It is a misconception. It is purely voluntary and only if they opt for the procedure the surgery is done,” Family Health Chief Dr. Deepthi Perera said.

“Now even we are trying to revise the age limit for this procedure. We are thinking of raising the age limit to 35 and above,” she said.

However, critics argue that the ban will only put older women at risk and drive them to illegal abortion. It is reasoned out that with the ban the older women who have teenage or adult children and would like to have an LRT procedure would be deprived. They maintain that women with grown up children would like to have a permanent method of contraception.

In such instances when and if they get pregnant they would not like to get help from the family planning units and would be pushed to other resources. Most often than not they will seek the help of illegal abortion clinics that would charge them exorbitantly and even put their lives in danger.

It is also argued that abortion parlours which would mushroom and quacks and half baked doctors would perform abortions on mothers most often using makeshift theatres and often not following sterilization methods that could turn aseptic and put the mothers at risk or even kill them.

The Family Health Association (FPA), also a family planning organization has shelved all its scheduled LRT procedures until further notice.

“It is banned, we cannot challenge the government’s decision … the repercussions would be unplanned pregnancies,” said a doctor at the FPA who wished to be anonymous.

“We use to do around 30 procedures once a month and now everything has to be cancelled,” the doctor said.

The Human Rights Commission welcomed the move and said that it is the right to life. Its Chairman Prathiba Mahanamahewa said according to the Human Rights Declaration of 1948 and the Political Rights Convention, everybody has a right to life.

“It is an individual right and this is another issue,” he said.

The Colombo Archbishop’s House also expressed its pleasure for the move to ban the birth control methods. “We believe that birth control and abortions are sinful and we welcome the move,” Fr. Benedict Joseph of the Archbishop’s House told Ceylon Today.

“The ban opens up for birth and it is in keeping with the teaching of the church,” he said.

LRT

LRT is a simple procedure done under local anaesthesia and is performed in a theatre for 20 to 30 minutes. The patient goes home the same day. The procedure will not have any effect on the menstrual cycle of the women.

Vasectomy

Male sterilization or vasectomy is a minor surgery taking only 10 to 15 minutes, also done under local anaesthesia. Post surgery there will be no effect on the sexuality or quality or quantity of the ejaculatory fluid of the person.COURTESY:CEYLON TODAY

MADHYA PRADESH HIGH COURT AT INDORE ISSUES ORDER ON THE RIGHT OF PREGNANT PRISONERS TO ACCESS MEDICAL TERMINATION OF PREGNANCY

INDORE - The High Court of Madhya Pradesh at Indore issued an order allowing Hallo Bi, a pregnant female prisoner, to exercise her reproductive rights under the Medical Termination of Pregnancy Act (Act). Hallo Bi had been sold into prostitution by her husband and after months of continuous instances of rape, she became pregnant.

In the order, the Court wrote, “We cannot force a victim of violent rape/forced sex to give birth to a child of a rapist. The anguish and the humiliation which the petitioner is suffering daily, will certainly cause a grave injury to her mental health.” This is a positive development for Hallo Bi and sets an important precedent for similar circumstances by affirming rape victims’ right to lawful termination of pregnancy under the 1971 Act. Unsafe abortions are one of the leading causes of maternal mortality in India with approximately 6.7 million abortions performed every year at unregulated facilities, often by medical practitioners untrained in abortion services.

In early December 2012, Human Rights Law Network (HRLN) Reproductive Rights Unit Assistant Director, Ms. Karla Torres, read an article in the Times of India about a pregnant woman who was in prison for murdering her husband and had been ordered to make a written application to the High Court for a termination of pregnancy. After communicating with HRLN advocate Mrs. Shanno Shagufta Khan in Indore and meeting with Hallo Bi, HRLN filed a petition requesting the High Court to allow for a medical termination of pregnancy.

The petition also stressed the Act’s silence on this issue and asked the High Court to issue guiding directions. As both the Act and the jail manual are silent on this aspect, the High Court had requested Hallo Bi to submit a written application for a medical termination of pregnancy. The High Court subsequently denied Hallo Bi’s application. HRLN’s petition stressed that the High Court had erred in not allowing Hallo Bi’s application as the power to refuse the same did not lie with the High Court.

Under the Act, the decision to terminate a pregnancy is between a woman and her doctor(s). As such, once a medical practitioner is of the opinion that the pregnant woman falls within the conditions laid down in the Act, a medical termination of pregnancy can take place. A court, therefore, does not have authority to determine whether a woman can or cannot terminate her pregnancy. Instead, a court can ensure that a woman who requests a medical termination of pregnancy under circumstances that satisfy the Act is provided with adequate medical care and services to fulfil her right to a termination of pregnancy.

Although the High Court found that Hallo Bi’s circumstances satisfied the MTP Act, the Court did not include guiding directions. Notwithstanding, HRLN plans to request a review of the petition so that this issue is taken up afresh and guiding directions are issued.